Grey Matters
by baillierj
Summary: Dr Sherlock Holmes is the hospital's new neurosurgical star. He performs miracles with his scalpel, but his bedside manner leaves a lot to be desired. The task to address the issue falls on one of the unit's senior neuroanaesthetists, Dr John Watson.
1. Hard to swallow

Dr John Watson knocks and enters patient room number 11 in the Neurosurgical Ward of King's College Hospital. He stops in front of the only bed in the room. Next to it stands a woman in her sixties, supposedly the Mrs Holborn whose chart John is holding. She seems to be frantically packing her things, assisted by a younger woman. Probably her daughter.

"Good afternoon," John says. "Am I in the right room? It seems as though you're leaving, Mrs...?"

"Holborn," The woman says, turning, "Anne Holborn."

"I wasn't aware you were being discharged," John says, slightly confounded.

"I'm not being discharged, I'm going home."

John glances at the chart, frowning. "I have you scheduled for an operation tomorrow. I was not aware it had been cancelled?" John inquires and adds, "I'm John Watson, I've been assigned as your anaesthetist for tomorrow. I'm here to discuss some issues."

The woman continues to pack, looking quite upset. He younger companion crosses her arms and regards John with an angry look. "We're not staying here a minute more. Honestly, I wish they'd told us sooner that the surgery would be useless."

John puts the chart down on a nearby table. "Look, Mrs Holborn and -?"

"Lucy Holborn. I'm her eldest."

"Could you please sit down, Mrs Holborn? It's obvious there's something going on that I wasn't made aware of. Could you please explain why you seem to have decided to withdraw consent?"

The older woman stops rummaging around her floral-patterned suitcase and slumps down onto the hospital bed. Her jaw is shaking as she is holding back tears. "It was that surgeon, he was just here, he told us that even with the surgery, I'm going to d-" She begins sobbing inconsolably.

The daughter leans down and puts an arm across her shoulders. "Mom, please. It's okay."

John grabs a chair and pulls it closer to the bed. He sits down and leans his palms on his knees.

The daughter passes Mrs Holborn a paper tissue from a nearby trolley.

"You talked to the surgeon. What did he say exactly?" John asks.

This time it's Lucy Holborn who speaks. "He said that he is certain he can get the tumour out but with this type and grade it'll just grow back later and-," she glances at her mother and inhales nervously, "Be fatal."

John checks the name of the neurosurgeon on the chart. A Dr Holmes. He's not familiar with the name.

Mrs Holborn has a grade three astrocytoma. It can't really be cured, but there's always a chance of a long remission.

"If I'm going to die anyway I'm not getting the surgery. I want to go home to my family," Mrs Holborn says slowly, sniffling.

John smiles in what he hopes is a reassuring manner. "While it's true that most patients will succumb in the long run, we can usually give them many great years with current treatments. Decades, even."

"Well he should have told us that, then!" Lucy Holborn says accusingly and leans on a wall next to the bed. Mrs Holborn has stopped sobbing but is still looking crestfallen.

"Look, sometimes surgeons are so focused on an upcoming operation that they can be a bit distracted. It's a good thing, really - it means that they're extremely focused. Unfortunately they can sometimes appear a little brusque," John says in an attempt to soften the tension.

"But that doesn't explain why he'd have to be so bloody cruel about it all!" Lucy says accusingly. "He didn't seem to care about Mom at all!"

John purses his lips. "I'm so very sorry to see you this upset. Maybe I could walk you through the surgery so you could have an idea what to expect. Then you can decide together what you want to do. Does that sound okay?"

Mrs Holborn looks out of the window and then at her daughter, who shrugs. "Couldn't hurt, I guess," Lucy Holborn says.

Mrs Holborn turns on the bed to face John.

He explains the usual course of the surgery and the post-operative care as meticulously as he can without emphasizing any potential risks in an unsettling manner.

When he has finished his explanation, he answers the many questions the two women have. Mrs Holborn decides to have the surgery after all.

It's half-past four in the afternoon when John finally excuses himself from the company of Mrs Holborn and her daughter. The daughter had thanked John for giving them a bit of hope after "that horrible man" had tried to completely take it away from them.

John wanders into the anaesthetists' lounge. It's been a month since he's last seen his colleagues due to a long-overdue holiday. He mostly spent it at his parents' house in Birmingham, apart from a short trip to Kent to see his sister.

The first person to greet him when he walks into the lounge and heads straight for the coffee machine is his ex, Dr Natalie Temple. They'd broken up a little before John's holiday. They'd been together for two years before the smoldering disagreements finally escalated into full-on war. Nat was smart but a little too much of a free spirit for John's tastes. They'd even tried an open relationship on her initiative. Even though John did have a reputation of being quite the ladies' man, his moral compass somehow never allowed him to seek other bed companions during their relationship. Natalie hadn't had such qualms. It wasn't the only reason for the downfall of their affair, but a large part of it.

It seemed that their explosive break-up was the best thing that could've happened because somehow they'd ended up as good friends again.

Their combined salaries had been enough to get them a very nice rental in Soho. Now that John was on his own, all he could afford was an abysmal little bedsit in Shoreditch. Maybe he ought to find himself a flatmate or something to get a bit more space for his stuff and a shorter commute to the hospital.

"Johnny!" Natalie calls out from where she's stretched out on a worn couch, "How was Kent?"

"Harry's drowning herself in a bottle again. Clara's moved out and they're getting a divorce."

"Which one came first, the booze or the divorce?" Nat asks. John had told her about his sister's tumultuous life when they'd still been together.

"Fuck if I know," John says and sips his coffee. He sits down onto the adjoining couch. The lounge is empty except for a cleaner mopping the floor. "Everyone else still busy?"

"Nah. I let the registrars home early since I'm on call and there isn't much on. Why are you still here? I thought you only had that laminectomy today, which ended ages ago. Just released the patient from obs back to the ward."

"Anything happen while I was away?" John asks, idly flipping through an old issue of the British Journal of Anesthesia.

"Not much. Oh, they finally filled that neurosurg fellowship position. Turns out there was this guy they were looking to headhunt the minute he got his consultancy, that's why the job has been unfilled for such a long time."

"Anyone we know?"

"I've heard of it but never met him before he got hired. Dr Sherlock Holmes? He invented that new anti-siphon valve a couple of years back that was all the rage in the conference circles. Did his training at The National, apparently."

The National Hospital for Neurology and Neurosurgery is the country's premier unit in the field. John himself had applied for a registrar position there years back and got turned down even though he had quite a decent CV.

"Weren't they sorry to let him go, if he's that good?" John asks.

Natalie leans back on the sofa, dangling her clog on her big toe. Eventually she loses control of it and it flops onto the floor, revealing a yellow sock with a smiley face on it. She mostly anaesthetizes patients for the pediatric surgery unit, and has made a habit of wearing funny socks and hats that she can use as a distraction while cannulating her tiny, needle-hating patients.

"That's the thing. He's supposedly really, really good with a scalpel, but I'm facebook friends with some of the gassers at the National and they all seemed to really hate his guts."

"What's he like, then?"

Natalie looks amused. "Well, as long as you don't talk to him and he doesn't talk to you, everything's just peachy."

End of chapter 1

xxxxxxxxxxxxxxxx

 **Author's notes:**

Welcome to the fascinating world of neurosurgery. In "The Road of Bones" I aimed for medical accuracy wherever I could, whereas in this story the goal was to have some adorable tropey fun with the AU concept. I have thus tweaked and twisted many medical facts for storytelling purposes. This is not a medical textbook. I'm using the names of existing British neurosurgical units in this story, but I know next to nothing about them. I have no idea what the quality ranking would be, or if there even is such data available.

Do correct me, British colleagues, if I'm wrong in any of these explanations. Also, I am NOT a specialized neuroanaesthetist, although I do handle neurosurgical cases on occasion. I'm more of a generalist gasman. Gasperson. Gaswoman?

Concerning preoperative visits: Practices vary between hospitals, medical specialties and countries but as a general principle the surgeon and the anaesthetist try to meet up with the patients and their accompanying family members prior to major surgery. They explain what's going to happen before and during the operation, and what sorts of plans have been made for the patient's care immediately after the surgery. If they haven't done so before, the surgeon will also explain potential risks and complications of the operation. The same usually applies for anaesthesia, if the surgery requires significant procedures such a cannulating major blood vessels.

A lot of minor operations are done on an ambulatory/day surgery basis, which means that the patients sleep at home before the day of the operation. In those cases it's difficult and mostly unnecessary to arrange a preop visit.

Astrocytomas are a common type of brain tumours. Grade 1 is quite benign and easiest to cure, Grade 4 is the worst and almost invariably fatal.

A registrar is a doctor who has graduated from medical school and who is well on his/her way in specializing in a certain field. When a registrar finishes his/her training, he/she will become a fully fledged consultant.

A laminectomy is a common type of back operation. As Mayo Clinic explains it, "Laminectomy is surgery that creates space by removing the lamina — the back part of the vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves."

Obs = observation. I'm not British nor do I work in the UK so I have no idea what doctors usually call this (patients being observed in a specialized, monitored post-anesthesia care area).

OR = Operating room. Also called an operating theatre for historical reasons. They used to sell actual tickets.

Fellowship = After a doctor has reached consultancy, ie is a fully licensed specialist in a certain medical field, they can seek additional training in a subspecialty by doing a fellowship, which I think usually lasts a couple of years. I'm using the term here quite loosely.

"New antisiphon valve" = Anti-siphon-type shunt devices are used to regulate the flow of cerebrospinal fluid in patients whose own regulatory mechanism are failing.

Clogs = Many doctors wear clog-like shoes for work in the ORs. They're handy because they cover your toes and therefore prevent all sorts of biological fluids and materials seeping into your socks (which is icky, I can tell you). (My current clogs are black, in case you were wondering.)

Pediatric = refers to something having to do with children

Gasser, gas man = colloquial for anaesthetist


	2. Up in arms

The next morning, John arrives at work early. He changes into a fresh pair of dark blue scrubs and heads down to the OR floor to make sure he has everything he needs for the day's cases.

After Mrs Holborn is wheeled into the induction area, he sets to work putting in the necessary cannules. He asks her if she has any last-minute questions.

"Dr Holmes is good, isn't he?" Mrs Holborn asks, sounding drowsy due to the benzodiazepine she has received as premedication at the ward.

John doesn't really know what to say. He's never met the man, and only has the hearsay Natalie had relayed to him to go by. He decides that at this point the most important thing is that the patient feels safe, so he opts for a deflection. "We'll do our very best for you, Mrs Holborn."

The woman nods, and lets her gaze wander up to the ceiling. John takes this a cue to start the induction. He injects Mrs Holborn with a combination of opiate, general anesthetic and muscle relaxant, and when they've all reached their full effects, he intubates her and after quickly moving her into the operating theatre with the assisting nurse, hooks her up to the ventilator.

It's only twenty past eight when the anesthesia is ready. The scrub nurse is humming while putting down drapes and arranging all the necessary instruments.

Suddenly the OR doors fly open, and a thin, raven-haired man in scrubs strides in with the confidence of a buffalo stampede.

John tries to say good morning but gets promptly ignored. The wiry man walks straight up to the instrument table and fixes his gaze on the scrub nurse. He does not look happy.

"Where's the 11 inch Kairison? I told you idiots twice last week that the 9 inch puts too much pressure on the feeding artery. Do I need to staple a post-it on your foreheads so that you would manage such simple matters correctly?"

The scrub nurse, an experienced woman with two decades' worth of experience dealing with moody neurosurgeons, regards her with a non-impressed look. "It'll be here in five minutes. I've sent for it since it was still in the autoclave after the midnight emergency craniotomy."

The man scoffs and turns on his heels. He strides out of the OR, probably to do the requisite wash-up before scrubbing in.

"What was that?" John wonders aloud at the scrub nurse, who rolls her eyes at him.

"That," she says pointedly, "Was Dr Sherlock Holmes."

An hour later, the surgery is well underway. The usual pop and rock radio stations preferred by most surgeons have been replaced with the contents of Dr Holmes' personal iPod. At current a violin composition is playing, and even though John is not an expert in classical music, to him it sounds a lot like the Bach pieces his sister practiced on the piano when she was in her preteens and was still forced to attend piano lessons by their well-meaning parents.

The surgical microscope's connection to the wall monitors has just been turned on and now all the staff in the operating room can see what's going on in the surgical field. At first the operation seemed slow-going as Dr Holmes made his way through the parietal cortex to reveal the tumour underneath. Now he has begun to explore its margins and slowly ligate all the vessels supplying it and has picked up speed.

John watches his movements on the monitor. He has observed the work of dozens of neurosurgeons during his career so far, and even though he's not a surgeon himself, he has begun to recognize skilled ones from fumblers. He's been an anaesthetist for eight years, out of which he has already dedicated fours years solely to neurosurgery.

He is forced to admit that not only is Dr Sherlock Holmes clearly very skilled and well-trained, he is extraordinarily fast and outstandingly daring. He handles the instruments with a precision that would be the envy of many a senior neurosurgeon. Mrs Holborn is lucky.

"Amazing," John muses and only realizes afterwards that he's said it out loud. "Brilliant," he can't help adding.

Dr Holmes doesn't raise his eyes from the microscope, but judging by what he says next it's clear that he's heard John.

"That imbecillic maunder will cease right this instant, or I will demand another team," he says icily.

John raises his arms in resignation. The scrub nurse and the assisting nurse award him sympathetic looks. John realizes they've all been awfully quiet during the surgery. Usually when things are going according to plan, there's gossip, idle chitchat and personal matters being discussed while the operation is ongoing. Clearly that is not allowed when Dr Holmes' is in the house.

The rest of the surgery goes swimmingly and Mrs Holborn recovers from anesthesia with flying colours, but John can't exactly say that he has enjoyed his day on the theatre floor.

"How'd it go, then?" Natalie asks him as they're walking to the tube station together in the afternoon.

"Fine, I guess," John says hesitantly.

"I've only done some spinal stuff with Holmes. D'you reckon he is worth all the fuss?"

They board the train and are forced to stand as other commuters have already taken over the seats. Thanks to King's College Hospital's proximity to several universities, there are also large groups of students on the train.

"I gotta say I'm impressed," John says. "How's he getting along with the other surgeons?"

Natalie laughs. "Well, Lestrade thinks he's the bee's knees, that he's gonna get us that foundation status they've been hankering for."

Dr Greg Lestrade is the head of neurosurgery, a down-to-earth, amicable gentleman who John sometimes plays squash with.

"The Botch hates him, obviously."

"Not surprised," John replies, grabbing a better hold of the safety pole as the train bucks and twists.

Philip Anderson is one of the unit's senior neurosurgery consultants, usually referred to as "The Botch" when the man himself is not within hearing range. As far as anesthesia has been able to figure him out, he's good enough not to kill patients all that often, but bad enough only to be allowed to perform simpler surgeries. Since he has not been able to compete in skill with other surgeons, he has focused on psychological warfare as his selected method to hold onto what little power he holds in the department.

"I heard a rumour that Holmes goes to sit in on other specialties' M&M meetings and always acts like a right smartarse, like he knows everything. Usually, he's right in his diagnosis suggestions, but still, who the hell does stuff like that?"

"Isn't it kind of refreshing, though, if a surgeon exists who hasn't forgotten everything that they taught us at med school apart from operating?" John asks with a grin.

Natalie looks thoughtful. "Sure, but even if I was the Einstein of diagnostics, I wouldn't go round to cardiology M&M to tell everyone that they're idiots."

John chuckles. "He actually did that?"

"Just hearsay, but I heard that he caused a bit of an uproar. After that Lestrade started to schedule his surgeries so that he can't go to most M&M meetings anymore."

"I'm on call tomorrow and I think I saw his name on the rota, too. I wonder what that's gonna be like," John wonders before saying goodbye to Natalie, who always changes trains at Paddington.

End of chapter 2

xxxxxxxxxxxx

 **Author's notes:**

Time for some term explanations again. Ask away if there's anything I haven't covered.

Anaesthesia induction = This is what we call the start of a general anaesthesia, ie this is when we make a patient sleep. We have to give them at least some sort of an anaesthetic (which makes them sleep), and usually we add an analgesic (which will blunt the pain and other harsh stimuli), opiates are usually the number one choice. If we need to intubate a patient and/or if the surgery requires it, we also dose the patient with a muscle relaxant after they've fallen asleep.

Induction area = In some countries/hospitals a general anesthesia is started in a room close to the OR, and the patient is transported from this room to the OR once they are asleep and their airways have been secured. I can't really discuss the benefits/downsides, because I've never used one. All my inductions happen in the OR.

Cannule = The straw-like thing that goes into a blood vessel. Usually we cannulate small, peripheral veins (veins in the hands or the feet) but arteries and larger (central) veins can also be cannulated when the need arises.

Benzodiazepine = A class of tranquilizer drugs.

Premedication = Patients are often given some medications prior to the start of a nerve block or general anaesthesia. Many different drug classes can be used, with pain meds and tranquilizers being the most common choice.

Intubation = This is when we insert a breathing tube into a patient's windpipe. Surgery inside the skull invariably requires this for several reasons.

Ventilator = "breathing machine". The modern ones are capable of many handy functions, not just "breathing" for the patient, although that is the main reason we use them.

Scrub nurse = Makes sure the surgeon has all the necessary equipment at his disposal and assist with the surgery.

11 inch Kairison = A pneumatic surgical instrument. I have no idea if they can be used in neurosurgery. I used the name here because it sounded pro. I know way less about surgical instruments than even beginner surgeons do. I'm an anaesthetist and not a scrub nurse, dammit! :)

Feeding artery = An artery that supplies a tumour or other sort of pathologic growth. I have no idea if a Kairison would be a good or a bad instrument for manipulating a feeding artery. Artistic licence, eh?

Craniotomy = a surgery that requires opening up the skull and doing something inside. Emergency craniotomies are required, for instance, when a patient has an expanding, catastrophic brain bleed that needs to be controlled and the blood removed.

Parietal cortex = a part of the brain; wiki/Parietal_lobe

Ligate a vessel = to tie a vessel so that if cut, the end won't bleed

M&M Meeting = Morbidity (=pertaining to illness) and mortality (=pertaining to death) meeting. A meeting during which recent patient deaths and significant care-related events are discussed. They provide a chance for doctors to air their grievances, discuss case management and receive peer support. We don't really have these in my country, but in the UK they seem to be a common thing.

Rota = Shift schedule

To be on call = This is when doctors take turns manning the hospital outside office hours; some senior doctors can take call from home, ready to return to the hospital within an agreed-upon time limit. More junior doctors and doctors whose skills focus on performing procedures that can be required within a moment's notice stay in the hospital for call. During on-call hours, if there's nothing going on, you might be allowed to retreat to an on-call room, usually a small room supplied with a bed where you can rest. This is never guaranteed - if the shift is busy, you might work through all of it. If things are slow, you might be able to spend a lot of time in the on-call room. Call can be interesting, challenging and offer a chance to handle cases you don't encounter during your regular practice. It can also be excruciatingly stressful, boring or nerve-racking. It's a love/hate thing, really, for most doctors - some aspects of it you enjoy, and some you absolutely loathe. The amount of call one has to take varies. At the moment I clock about 20-40 active on-call hours a month.


	3. Things coming to a head

Oh, the bliss of sleep.

John closes his eyes, listening to the hum of the air-conditioning. He has finally gotten a chance to retreat the the solitude of the anaesthesia on-call room after staying up until 3 a.m. supervizing the junior registrar, handling a lap-chole and a perianal boil drainage and installing two central lines.

He's floating somewhere between exhaustion and sleep when the on-call phone starts ringing. John curses, flicks on the small lamp attached to the wall and fumbles around for the phone.

"Watson, anaesthesia," he says into the phone, trying to will himself to wake up properly by bleary-eyed blinking.

"About time. Do you usually answer on the sixth ring? Never mind that, I've got a 53 year old male with an expanding left hemispheric intracranial hemorrhage. 1 centimetre midline shift. History of smoking and high cholesterol, no regular medications and no allergies. I require an emergency craniotomy arranged stat."

"Who is this?" John inquires while dragging himself up to a sitting position.

At the other end of the line, the caller inhales quickly. "As I already said, a male of 53 years -"

"I meant who's _calling_," John interrupts.

There is an indignant silence at the other end. "This is Dr Holmes. I assume I am speaking to John Watson, on call for anaesthesia?"

"Damn right you are," John says, already pulling on his scrub pants while holding the phone between his cheek and his ear.

"Oh," comes the disinterested reply.

"Sugita?" John inquires as he slips his feet into his sneakers.

"Obviously," Holmes replies sharply.

"I assume there'll be ICP monitoring afterwards?"

"I have to say, Dr Watson, that if you are indeed a senior neuroanaesthetist in this facility, I am sorely disappointed in your rather elementary questions that even a senior house officer should be able to-"

John is now very awake and very annoyed. "Look, I always ask at this point and all the others understand that I need to, because how else will I know which of those monitors to get for you, Codman, Camino or Ventrix?"

"Oh," says Holmes distractedly. "Codman, then."

John is tempted to tell the uppity man to say please, but he's already hung up.

Two hours later, sweat is glistening on John's forehead as he tries to stabilize the patient's blood pressure. The bleed is showing no signs of spontaneously slowing down, and its source is proving difficult for Dr Holmes to isolate. Blood is gurgling down the suction tubing into the collection container, and the assisting nurse has just run to the service elevator to get the second helping of red blood cells and fresh frozen plasma that John has ordered. It won't be much help, however, if the bleeding won't stop soon.

The blood pressure begins dropping a little too fast for John's liking. The patient hasn't produced any urine for an hour, and the pressure curve of the arterial line is beginning to point to extreme lack of circulating blood volume.

"Dr Holmes?" John asks, alarm in his voice.

There's no reply.

"Dr Holmes!" John says loudly.

The man's gaze narrows but he doesn't look up from the microscope. "Speak, but be quick about it," he says impatiently.

"I think he's about to exsanguinate."

"Oh really? That is surprising, considering that you're all the way over there, and I'm here right in his pretty little brain. How could I ever notice anything like that?" Holmes says in a mocking tone. "Concentrate on your own bloody job and I shall do mine."

"I can't get this stuff in as fast as it's draining out," John says in a pleading tone.

The monitors begin emitting a shrill whine. The blood pressure has tanked despite John's best efforts. The assisting nurse runs in with the blood products, but it's no use. The patient's saturation is dropping as there isn't enough hemoglobin in his circulation to match the tissues' demands for oxygen.

On top of if all, John can see that the patient's brain tissue has begun bulging out of the craniotomy hole.

Uncontrollable brain swelling. John has already attempted all that he can to control it, even hyperventilating the patient with the hopes of that temporarily constricting his blood vessels to make some space within the skull.

Sometimes nothing works.

Sometimes a patient is dealt a bad set of cards from the start.

"He's gone," John says, when the blood pressure is no longer measurable. The ventilator is still on and there's still a saturation reading somewhere in the low fourties. The brain has likely herniated through the natural openings of the skulls, rendering all centres of awareness, breathing and other vital functions irreparably damaged.

The scrub nurse and the assisting nurse nod. They cannot see one another's full expressions but their eyes share an understanding of what has transpired.

Everything slows down. Everything but Dr Holmes, that is.

John wanders next to the surgical tray table. "Dr Holmes, I think it's time to stop," he suggests quietly.

"Nonsense," the man replies without a hint of nervousness of any other kind of emotion.

John wonders if this is a stress reaction, a bit like being shellshocked. He's seen it before, mostly in very young surgeons-in-training, when they can't face the fact that their patient is in the process of dying on the table.

"Dr Holmes, there's likely fatal herniation and the rhytm's going erratic."

Holmes looks up and their eyes meet. The surgeon looks very annoyed. "I am well aware of that. Why are you bothering me?"

"Aren't you gonna close up and call the family?"

"I'm going to finish the operation. The field is now bloodless and this is a fascinating case."

John steps back, disconcerted.

The scrub nurse leans her palm onto the patient's draped shoulder as though seeking support. "John?" the nurse pleads, obviously wanting John to put his foot down and spare their patient from being dissected any further.

"Sure it is a good case," John says, his words directed at Dr Holmes, "But I think it's time to let him die in peace," he tries.

Holmes squeezes the scalpel in his fingers and then lets it clatter onto a tray. "Die in peace. Die. In. Peace. Do explain, _Dr_ Watson, your reasoning of why collapsing in the toilet and ending up on this table somehow counts as a peaceful passing for this man?"

"You know what I mean."

"All I know if that you have the utter gall to distract me with emotional drivel worthy of a soap opera, when I'm trying to perform surgery."

"It's not surgery if the patient is dead!" John says, more loudly than he had intended. He is tired, weary, sad and damn it if he is going to let this heartless idiot slice up this man who is probably someone's husband, father, neighbour and friend, just because they want to have some fun scalpel practice. "It's grotesque and I won't have anything to do with it! No wonder you upset Mrs Holborn so badly! It's obvious you're pretty fucking skilled with your hands, shame that what goes on in your head more resembles a fucking butcher than a proper surgeon!" John realizes that what he has said is not very collegial, and that airing such grievances in front on non-doctor staff is really not on, but he needs to get his point across.

It's suddenly very quiet. The scrub nurse is frozen in place and the assisting nurse has practically hidden herself behind the anaesthesia workstation.

Holmes steps away from the patient. Then he turns his oddly multicoloured, piercing irises towards John. His gaze is scorchingly furious, and the man seems to have grown a few extra inches as he practically towers over the dead patient, his entire attention now focused on John.

"You can't go round like that, stripping all hope from people who come to you for help!" John adds in an accusing tone. He might as well let it all out now.

"Hope," Holmes parrots with a venomous tone, "What you call hope is looking for flimsy excuses for selective ignorance and false expectations. It is intellectually dishonest and frankly, I think it's a rather weak display of a doctor's character to rely on such falsehoods."

"Doesn't mean you can go about things like a bloody elephant in a china shop," John replies quietly.

"Get the hell out of my OR," Holmes tells him.

John crosses his arms. "No fucking way. Technically, I'm your superior since you're a fellow."

They glare daggers at one another for a moment. Then John's mouth curves into a slight smile. He feels much calmer now. He turns to the assisting nurse. "Fiona, be a dear and switch off the vent. I'll call the ward."

Holmes pulls off his gloves with a snap and throws them onto the instrument tray, seething with displeasure. "I shall call the relatives," he announces, and storms out of the OR.

The minute the door closes behind him, the nurses break into applause.

John is secretly happy that the rest of the week he doesn't get assigned to any of Dr Sherlock Holmes' surgeries.

On Friday Dr Lestrade lingers behind in the OR after a spinal operation, while John starts preparations for waking the patient up.

John likes Greg Lestrade. The man often helps the team out with lifting and turning the patients for back operations - a risky phase in the anaesthesia process as anything from the intubation tube to intravenous cannules could dislodge, resulting in a potentially life-threatening problem. Many surgeons simply slip out of the OR the minute the last suture is tied, not paying any attention to what still needs to be done before the patient can be wheeled out of the OR.

Lestrade understands the ethos of the anaesthestists, since he used to be one himself before hearing the call of the knife, as he has described it. He communicates his wishes clearly but amicably, and is always open to discussion about a patient's eligibility for anesthesia or the minutiae of postoperative care.

When most of the other staff are out of earshot, Greg leans on a suction machine and regards John with an amused expression. "I heard you gave Holmes a bit of a lambasting the other day," he says.

John starts inching off the tapes holding the intubation tube in place, glancing at the monitors to ensure that the muscle relaxant is no longer in effect. "Look, I know it's not my place, but he was way out of line."

"I've talked to him about it. He says that you argued on behalf of the patient's dignity."

"That's one way to put it. Look, I know you think highly of him and he's not the only surgeon in the house whose bedside manner needs a bit of refining. I don't want to step onto your territory. He's your responsibility, not mine."

Despite what John has assumed, Lestrade does not look disapproving. Far from it. "I wanted to thank you, John. He's... skilled, but is proving a handful. He's under quite a lot of pressure."

Lestrade then leaves the OR, leaving John to wonder what the man's cryptic statement had meant.

Weren't all surgeons under pressure every day that they operated? Didn't every anaesthetist experience a lot of stress every time they handled a challenging case? Sure, Holmes was an up-and-comer, eager to show his skills and prove that he had earned this coveted fellowship, but judging by what John had seen of his talents, surely Holmes wasn't going to have any performance problems in the technical aspects of neurosurgery.

What is Holmes' problem, then?

End of chapter 3

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 **Author's notes:**

Time for the lexicon bits.

Lap-chole = laparoscopic cholecystectomy. A common operation during on-call hours. The gallbladder is removed through small wounds made in the abdomen.

Central line = a line inserted into a large vein usually under the clavicle or at the base of the neck. Can vary in thickness from a toothpick to a straw.

Expanding left hemispheric intracranial hemorrhage = a brain bleed that is still continuing, located on the left hemisphere

Midline shift = when there's extra stuff in the brain like a bleed or a tumour, the normal brain tissue will shift when the pressure inside the skull builds; a significant midline shift signals that it's a major emergency as the brain is at risk of bulging out of the skull

Sugita = a metal contraption into which a patient's skull is fastened with screws

ICP = intracranial pressure, ie pressure level inside the skull. There are many different ICP monitor manufacturers, some of which John lists here.

Saturation = normal oxygen saturation is above 94%. A reading in the forties signals a disastrous situation.

What John and Sherlock are working on here is an emergency craniotomy - a very, very urgent operation. They're not uncommon - I usually handle one or two per 1-3 on-call shifts. They're stressful, fast-paced and can end exactly like this when the patient's prognosis was dismal to begin with. Still, we try what we can. I'm happy to tell you that I've never been in a situation like the one depicted here, where the anaesthetist and the surgeon aren't on the same page when the brain herniates and the situation turns hopeless - it's a situation in which collegiality and mutual respect are of utmost importance.


	4. Spilled guts

On Thursday evening John retreats to an empty office to write evaluations for the medical students he has been teaching. He had taken up some instructing duties to earn a bit of extra cash. It still wouldn't be enough for a nicer flat, but at least it would get him some extra post-call pints and some of the nicer ready-meals from Tesco's.

He yawns and switches on the lights, since sunlight is no longer streaming in through the windows. Twilight has set in and lines of cars are beginning to form outside the hospital as evening shifters are heading home.

It's late but John doesn't long for home. After breaking up with Natalie there's not much in his life to keep him occupied during his hours off work. He watches TV, surfs the web, sometimes walks to a nearby pub to stare into a pint for an hour or two.

His work schedule drains his energy to the extent that he doesn't really feel like dating anyone. Nat had been convenient since they worked together.

That's all that it had been - convenient. Not a fairytale romance.

That had happened to him before - ending up somewhat long-term with someone who was just okay. Lukewarm dates, sufficiently entertaining sex, shared cups of tea in front of the telly. It was all nice and cosy, but somehow always left John longing for something that was a little... more. It never left him, that nagging suspicion that somewhere out there was someone who wouldn't make him feel like he was settling for less. Someone more exciting. Someone who could keep him on his toes and then knock him off his feet.

John shifts aside the evaluation he's just proofread and pulls another one from the pile. He opens some drawers to find a better pen instead of the leaky one he's been using, but before he finds one there's a knock on the door.

"Yeah?" John calls out, leaning back in his chair.

The upper half of the office door is made of frosted glass, and thanks to the dim corridor light shining through it John can make out a thin shadow behind the door. Whoever is standing there seems to be hesitant to enter.

"Come in," John says a bit more loudly this time and finally, the door opens.

His eyes widen in surprise when he recognizes the visitor.

Sherlock Holmes.

"Evening," Holmes greets him dryly, closes the door behind him and after taking two steps closer, stops to stand in front of the desk John is occupying, hands clasped together behind his back.

In John's eyes Holmes looks guarded, expectant and a little... shy? It's a sharp contrast to the manner he has been behaving in the OR, with the rest of the staff present.

What the hell is going on?

"What can I do for you, Dr?" John asks, keeping his tone neutral, "Come to give me an earful about what happened last week?"

Holmes blinks. "No. Far from it. As far as I'm concerned, that's water under the bridge."

John wonders if Lestrade has been talking to the man about the incident. It seems likely.

There's an empty chair opposite John and Holmes leans his palms onto its backrest, as though looking for some sort of fortification. John realizes that his initial assessment had been correct - Holmes is nervous. Why?

John puts away his papers. "Well, what then?"

Holmes swallows and narrows his gaze. "I was wondering if you could assist me in a... certain matter."

John smiles. "I'm gonna need a little more than that before signing up."

"You teach medical students," Holmes says, articulating the word 'students' as though he's describing someone ingesting rusty nails.

"Sometimes, yes."

"And you evaluate them on their conduct in communicating with patients?"

"Among other things, yeah."

"Back at The National, a patient died on the table. She was the wife of the head of the whole institution's board of directors. He's a prestigious urologist and somehow convinced that her death is on me, that I was somehow neglectful or downright erroneous in handling the case. He has taken the case to the Medical Council and is petitioning that I am unfit to be a physician."

No wonder Lestrade had been saying that Holmes was under a lot of pressure. A Medical Council hearing was never a laughing matter. John had always considered himself lucky for never having had to go through such a process.

"Well, how do you see it all?" John asks, putting down the pen he's been twirling between his fingers.

Holmes sits down on the chair, looking relieved. John suspects this is because talking about such matters among colleagues rarely happens because it feels quite embarrassing even if the doctor in question has done nothing wrong.

"I have reviewed the records dozens of times. I cannot find any fault in my conduct, and neither could Dr Halloran, the head of neurosurgery at The National."

"Well, you shouldn't have much to worry about, then," John says amicably.

"There are other aspects in the inquiry they've opened. They have to do with my personality. I fear they might require me to undergo some sort of an evaluation."

John realizes there's more to it than that. "Go on."

Holmes is now lacking his usual arrogant manner. He somehow looks younger.

Holmes runs a hand through his hair nervously.

John leans his elbows on the table. "Look, whatever it is, I promise it won't leave this room."

Holmes looks up and into John's eyes, scrutinizing him. John feels as though he's now under the surgical microscope.

"I can trust you?" he asks quietly.

John marvels at the scene. How is it that the man he has very recently yelled at and berated quite harshly in now seated in front of him, about to spill some sort of a dark secret of his? Does Holmes truly have no one else he could have approached?

Holmes bites his lip and then exhales. "When I was in my late teens, I had some... issues. Substance abuse, mostly. Two accounts of assault. I was diagnosed with Asperger's syndrome and some sort of a personality disorder the type of which the psychiatrists could never quite agree on."

John stops himself from gaping. That explains a lot.

Scratch that. As far as John is concerned, it explains _everything_.

Then realization kicks in. "Wouldn't all that have come up in your medical college entrance process?"

Holmes looks triumphant. "I had the advantage of perfect GCSE scores and a brother who can make certain records disappear."

"How'd you fare at university, then?" John asks, thinking that if Holmes clearly had trouble with people at his current age, things couldn't have been easier for him when he was younger. Medical students can be quite tribe-like in their social circles, shunning those not fitting the perceived mold of a typical wannabe doctor.

In John's opinion someone like Sherlock Holmes would've felt much more at home in the natural sciences department - those fields didn't require or idolize the kinds of social skills that were demanded of doctors working with patients.

"Assuming by your thoughtful expression, I think you have already imagined some sort of a possible scenario," Holmes says in a resigned tone.

"We all had aptitude interviews after advancing from House Officer to registrar. How'd you swing that?"

"By that time I was already a published researcher with a patent under my belt. They took me on with the proviso that I attend therapy twice weekly and seek to improve on my communication skills."

"Has therapy helped?" John asks.

Holmes looks sardonic. "I have no idea. I've been forging the reports for six years."

"So if the Council tries to contact your therapist, they'll find out you never actually did any of it?"

Holmes looks at his shoes. "All they need to do is to find out that a therapist by that name doesn't even exist. I assume you understand my predicament now."

"I do, but what could I possibly do about it?"

"You teach students how to become sensible doctors. You seem sensitive to issues pertaining to doctor's behaviour. Perhaps you could help me conduct myself in a manner that would help convince the Council that no further evaluation was necessary. You seem to have a good rapport with staff and patients. Everyone likes you," Holmes says, sounding as though the last part is something quite alien to him. "They don't like me," he adds.

"You don't give them much of a chance," John points out.

"Meaning what? I strive to communicate my requirements concisely and clearly. I am never late, I turn in the requisite paperwork in time and I am very good at what I do in the operating room."

John rubs his forehead with his thumb, closing his eyes momentarily. "You could try being nice to people," he suggests.

"How is being nice going to help the patients?"

God, he is completely clueless, isn't he, John wants to tell himself. Still, he can't help but feel honoured, intrigued and a little worried, even.

It's becoming clear that this man is not the arsehole everyone thinks he is. He just doesn't know any better.

"Look," John says, "I can't change all that in a short period of time. I can't hope to change _you_, stuff you've dealt with just to get the Council off your back. I'm not a therapist - I wouldn't even know where to start!"

Holmes looks disappointed.

"Hey," John says and the man looks up, "I didn't say I couldn't help."

Holmes frowns. "What do you mean?"

"If we want to get this all to go away and get you back into the OR where you so clearly belong, we just have to do one tiny little thing."

Holmes looks intrigued and seems to be urging John to continue with the excited and expectant look he's giving the man.

John stands up. "We'll just have to solve this case of yours, then, don't we? Find out why she died. Do a bit of detective work. How's that sound?"


	5. Picking brains

They make a plan to start from the records office of the National Hospital for Neurology and Neurosurgery. John assumes they would be going there during the office hours, but Sherlock insists on leaving right away.

"I conveniently forgot to turn in my electric passkey when I changed jobs, and most of the IT department is still on holidays so I doubt they'll have deactivated it. Probably waiting for the influx of new house officers in September to do it all in one go," Sherlock informs John while

hailing a cab from in front of the hospital.

"Still, that won't get us into the Records Office," John points out as they clamber onto the back seat.

Sherlock gives the address to the driver.

"It's another lucky coincidence, then, that I happen to be an excellent lockpick," Sherlock then announces triumphantly.

John steals a glance at the cabbie, who doesn't seem to have heard anything. "Is there anything you're not bloody excellent at?" John asks in a way that's meant to be rhetoric.

Holmes' lips are parted and he's looking at John as though the man has truly done something appalling. "You already know."

John swallows. "Right. Sorry."

Sherlock leans back, watching the lights of London drift by. "Why would someone become an anaesthetist? You want to be in the OR but aren't interested in operating yourself. How does that work?" Instead of mocking, his tone is curious.

"In case you haven't noticed, there's a lot of stuff going on in the OR besides the operation itself. I like handling all that's going on in the background, multitasking so that you can do your job."

"But you can't _fix_ anything," Holmes points out.

"I don't have to fix things in order to help patients. I help you people fix them. I see to it that they're not in pain or distress. If that's not helping then I don't know what is."

"'We people'?"

"Surgeons," John says, smiling. "I'm kind of surprised that you wouldn't have chosen some field that wasn't more suited to your intellectual capabilities. It's obvious you're kind of smart."

Sherlock looks as though John has called him something much less flattering. "Just using my brain would've been entertaining, but combining what I can do with this-" He points at his own head, "With a bit of manual dexterity," he adds while splaying out his pale, long, thin fingers, "Is irresistable."

John finds himself staring at Sherlock's hands but forces himself to snap out of it.

"Well that's reassuring. Most of the gossip mill just thinks that you like cutting people open and this is the only way in which to do it legally," John scoffs.

Holmes shoots him a dirty look.

"I will concede that without anaestesia the work would be infinitely more challenging."

John laughs. "Thanks. The patients also seem to appreciate being knocked out for what you do."

They request the driver to leave them at one of the maintenance entrances. Sherlock's electronic passkey still works, and they manage to enter the building without being seen by anyone.

"How about you tell me a brief version of what went down, so I can start figuring out what to look for?" John suggests, as they walk down a dim corridor with blinking fluorescent lights.

"It was a pontine oligodendroglioma, grade II, likely curable with surgery. It's localization made it prudent to utilize a sitting position during the surgery."

John nods and walks into the elevator, the door of which Sherlock is holding open for him. "Posterior fossa?"

"Obviously," Sherlock says with a disappointed tone.

"Sometimes people say things like that, reaffirm what you're saying, because they want to signal that they're listening," John suggests.

Sherlock looks thoughtful as the elevator begins descending. "I know you're listening. You look focused and interested and you're maintaining eye contact. I don't need idiotic remarks to affirm that."

"Alright, alright, go on."

The elevator comes to a halt in one of the basement levels.

For a brief moment John second-guesses what he's doing - allowing himself to be lead down dark corridors into the cellars of an empty building by Sherlock Holmes.

Still, it's all a lot more fun than writing registrar evaluations.

"Is this case the reason why you chose to come to King's instead of doing a fellowship at The National?"

Holmes looks circumspect. "No."

"Well, why then?"

"As I have told you before, they didn't like me very much," Holmes says quietly.

"Silly me, thinking that you didn't particularly care about what people think," John says.

Sherlock does not meet John's gaze. Instead he exits the elevator, clears his throat and his expression turns more determined. "After a succesful removal of the tumour I was verifying hemostasis, when the anesthestist informed me that he suspected that the intubation tube had come loose. It was checked and found to be still intact. The patient's saturation began dropping, and the anaesthetist informed me that he was getting a capnometer reading again but that it was strangely low. He called in a senior colleague, and a preliminary diagnosis was made of a suspected air embolism. They quickly inserted a large-bore CVC, through which they seemed to manage to draw out some air. Ventilation stabilized, but the patient began convulsing and went into sudden asystole."

The elevator doors close behind them and darkness falls. John fumbles around a nearby wall for a light switch.

When he finds it and turns, he yelps as Sherlock is standing right behind him.

He bumps into the man, who takes a step back and looks at John with a mixture of amusement and curiosity. "Scared of the dark, Dr Watson?" Sherlock drawls in a low voice, and the hairs on the back of John's neck stand up.

"Lead the way," John says quickly and Sherlock begins walking down the now well-lit hallway towards a distant door marked 'Archives'.

It takes Sherlock two minutes to pick the lock. John stands behind him, keeping an eye on the hallway. There's no reason anyone would come down there at this hour - it's nearly nine in the evening, but there's the possibility that a guard might round the whole building.

The door opens with a faint click and Sherlock flings it open. "After you," he tells John and holds the door open for his colleague.

The task falls on John again to find the lights and after he does, they spend a few minutes figuring out the filing system. Despite its revolutionary reputation in terms of cutting-edge surgery and other treatments, The National still relies heavily on old-fashioned paper records. John feels grateful for this - somehow traipsing around basements in the dark feels safer and more anonymous than hacking some NHS central server. He wouldn't have been surprised, however, if Sherlock's genius extended to IT as well.

They find the records of Myra Jean Baxter and spread them onto a desk. John goes through the anaesthesia charts while Sherlock browses lab prints, imaging reports and his own chart markings.

"I assume she tanked after the embolism, then?"

"Resuscitation went on for 44 minutes. Nothing worked. The embolism seemed to have been massive."

"They hadn't put in a central line before the surgery?"

"No, they don't do that routinely and I remember the anaesthetist saying that she had good peripheral veins."

"Surgical field irrigation was done, I assume?"

Sherlock crosses his arms after putting down the chart he'd been holding. "The National is a top unit in the country. Do you honestly suspect they would neglect such a elementary detail of posterior fossa surgery?"

"Have you seen this?" John asks, holding up an autopsy report he has found at the bottom of the folder.

"They wouldn't release that to me since the official inquiry had already started. I did manage to procure the death certificate, but you know how that goes, they're always so generic."

John pushes aside the rest of the records and sits in the chair next to the table. He begins reading the autopsy report.

Sherlock has leaned closer, reading over his shoulder. John feels the man's breath on his left ear, which is distracting him.

It shouldn't be.

John often has to work in cramped conditions with his fellow staff since the surgical instrument units often take up so much space in the OR that little is left for anaesthesia to maneuver around in. John doesn't remember ever being so aware of such close proximity to someone in a work-related situation.

It seems that Holmes has an uncanny skill in keeping John on his toes. He's not sure whether he likes it or not.

"What are you looking for?" Sherlock asks quietly, the exhaled words ghosting warmly on John's cheek now. He blinks and leans forward to get a closer look at the autopsy details.

John points his finger on the paragraph describing the patient's heart. "Patent oval foramen. Under normal circumstances small amounts of air always get into the vasculature, but if there's a pathologic atrioventricular route present-"

"Even a small amount will cause significant neurological symptoms," Sherlock completes his train of thought.

"And if the patient got a substantial amount of air into their system, most of that would go to the lungs and cause typical lung arterial embolism symptoms, but with a patent foramen a small amount might get into the brain and totally wreck the scenario. Convulsions and asystole could be signs of that."

"But asystole could also be a late result of significant right ventricle strain, as in massive lung embolism," Holmes says and begins pacing around, looking thoughtful.

"Who checked the preop results?" John asks.

Holmes strides back to the table and rummages around for his notes, sending most of the papers flying onto the floor. "Aha!" he says, lifting up a sheet of paper so that John can see, "The anaesthetist signed off on the heart ultrasound results. I must've not gone through them myself, since he'd already done so."

John digs out the ultrasound report page from the folder. "Look at the date. He's signed off on it three days before the ultrasound was even performed!"

"But if those are her ultrasound results, what's that then?" Holmes points on the floor towards a very similar-looking printout and picks it up. It has the patient same name and the same social security number in the self-adhesive label attached, but the results are dated a week earlier than the anaesthetist's signature.

The results are different.

Holmes turns, hands raised, looking agitated. "This is the one he must've seen and signed off on, then!".

He turns to face John, suddenly smiling deviously. "Brilliant, John, absolutely marvelous!" he exclaims but then looks slightly embarrassed, as though he hadn't meant to say anything of the sort.

John reaches for the result strip still between Sherlock's fingers and the man lets go of it. John puts both ultrasound reports on the table next to one another. "This patient has a prosthetic aortic valve. Unlikely finding in a woman of this age. Does it say anywhere in her records that she's had cardiac surgery done?"

Holmes is looking giddy and triumphant. "No, nowhere! She was supposed to be healthy apart from regular thyroxine medication for hypothyroidism. She was euthyreotic at the time of the surgery, I remember checking that."

John stands up. "Well, there you have it, then. They simply mislabeled someone else's result slip."

John shakes his head in disbelief. Quite a close call. The case could've been big and dragged on for years without this epiphany. "I think that this'll win you your case easily and with an added bonus of not having to nail the anaesthetist to the cross. Not that you'd care about that, but-."

Sherlock suddenly turns his head towards the corridor and raises a finger to quiet John. They listen carefully.

"Someone's coming," Holmes mouths to him and John makes a lunge to flick off the lights. Holmes grabs his arm and pulls him down onto the floor behind a filing cabinet so that they will not be visible from the hallway.

Sherlock is still holding onto him, slender fingers curled around his arm. They're kneeling side by side on the floor.

John can barely make out Sherlock's outline in the dark, but in the cool basement air he's acutely aware of the warmth radiating into his bicep from the man's palm, and the faint mixture of sweat, some sort of floral shampoo and a minty aftershave tickling his nostrils.

The hold on his arm disappears, and John is shaken out of the strange reverie that Holmes' proximity had lulled him into.

A set of footsteps approach, advance past the door and then return the way they came. The hallway light is switched off and the elevator whirrs into life. They must've not heard the elevator's arrival before since they'd been talking.

Sherlock stands up, dusts his trousers and turns on the lights again.

John gathers the patient records back into the folder and replaces it in its rightful place in the cabinet.

They then leave the archives, take the elevator up and sneak out of the building. When they arrive at the road in front of the hospital, John lets out the breath he hadn't realized holding. He's on edge, giddy and exhilarated in a way that work almost never makes him feel.

Was it the sneaking around a strange hospital in the dark? Or Sherlock Holmes? Or both?

"That was... Something," John blurts out and leans onto a stone wall where the name of the hospital is written with embossed brass letters.

Their eyes meet.

Something incandescent seems to emanate from Holmes' gaze and his triumphant smile is infectious. John giggles and after awhile, Holmes joins in, leaning his arm onto a nearby lamppost.

"This one of your hobbies, then, breaking and entering?" John asks, sticking his hands into his coat pockets.

"If you're referring to the lockpicking, that is merely something I taught myself as a child to pass the time."

"You didn't have any toys, then to keep you busy? Or friends?" John asks without deliberating very carefully what's coming out of his mouth as he's still feeling almost drunk on the excitement.

Something shifts in Holmes' gaze. He doesn't look all that amused anymore. "The hearing is four days from now. You must tell me how to thank you for this. There is a possibility neither I nor my barrister would have noticed the date discrepancy." He makes the latter sound like a concession.

John flicks a dismissive hand. "Don't worry about it. I had fun, we cracked your mystery, all's well that ends well."

"Surely I could assist you in some manner in the future if need be?"

John shifts his balance. "Look, I'm always happy to help out a colleague that the Council is trying to chew up for nothing. Honestly, it's fine. Not a big deal."

Holmes looks contemplative. "I'm aware that it is customary for criminals to share an alcoholic beverage after a successful heist."

"I'm not sure I'd class us as any kinds of major kingpins yet, and if you're referring to getting a pint, I'm gonna have to take a rain check. It's pretty bloody late, my stuff is still at the hospital and I have to be at work tomorrow morning. I assume you do, too."

Sherlock now looks more disappointed than John would ever have assumed.

Had Sherlock actually wanted to go and have that drink, or was the man just trying to be polite?

Going to a pub with Sherlock Holmes - kind of preposterous. Holmes didn't seem like the sort of guy to share his life over a Guinness.

What would they even talk about?

John flashes a jovial smile and hails down a cab. "See you tomorrow," he tells Sherlock and climbs into the vehicle. The cab heads down Southhampton Road.

Sherlock is left standing on the pavement, watching the car's taillights until they disappear.

End of chapter 5

xxxxxxxxxxxx

 **Author's notes:**

The way in which John describes anaesthesiology is a simplification but in essence, accurate. The surgeon operates, while the anaesthetist is basically responsible for taking care of everything else: the anaesthesia itself, fluid and electrolyte balance, temperature, positioning (although surgeons often help set everything up in the beginning of the operation), the patient's lung function, breathing and the respirator's settings, ordering blood products, preventing nausea and postoperative pain... The list goes on and on. It truly requires multitasking.

Pontine = located in the brain stem

Oligodendroglioma = a type of brain tumour, grade II being mostly benign

Posterior fossa = The posterior fossa is a small space in the skull, found near the brainstem and cerebellum; to access it, a sitting position is often used in surgery

Hemostasis = control of bleeding in the surgical field

Capnometer = a machine measuring carbon dioxide emitted from the lungs into the tubes of the respirator ("breathing machine")

CVC = a central line = a central venous catheter, a cannule inserted into a large vein used for, among other things, quick infusion of fluids and blood products; it can be used to suck out air bubbles from the patient's main lung artery

Ventilation = exchange of gases (i.e. air, carbon dioxide and so forth)

Asystole = "flatline"; a patient's heart is not functioning; not even the pacer cells are trying to make the heart muscle do anything

Embolism = stuff getting stuck in the wrong place in a patient's circulation; a common form of this is a blood clot traveling from a patient's leg vein into the lungs but other stuff such as fat from a fractured bone or air from a surgical cut in a blood vessel can cause embolism

Patent oval foramen = we all have a hole in the wall between the heart's atriums when we're fetuses but it's supposed to close after birth. In some people it persist and usually doesn't cause much grief unless such a person undergoes sitting brain surgery for reasons that John and Sherlock explain here. A cardiac ultrasound can usually tell if such a hole persists but it's not foolproof

Pathologic atrioventricular route = John is going whole hog on the lingo here. What he's saying is that there's a hole in a patient's heart that shouldn't be there, that's all :)

Right ventricle strain = in this scenario the right side of the heart is put under huge stress when it can't pump blood normally into the lungs because there's something wrong with the lung vasculature

Euthyreotic = fancy term for a patient's thyroid condition being so well-managed that they have normal levels of certain thyroid hormones in their circulation


	6. Seeing eye to eye

The next morning John spends half an hour trying to reorganize the neuroanesthesia unit's assigned surgeries because one of their consultants has called in sick. It's flu season and thus the occurrence is not unheard of, but due to one of the seven consultants already being on research leave they will be stretched thin. John takes a demanding case off the hands of their registrar since there's no one available to supervize her. Besides, it's Holmes' case and John doesn't think it's fair to expose this young, shy female registrar to the fire and brimstone that Holmes can be when things don't go the way the man wants.

In all honesty, John had been secretly glad that he wasn't supposed to be working with the man for a few days. As much fun as John had had during their strange outing, the whole evening had left him with some conflicted feelings.

He'd shouted at Holmes, and the man had still come to him for advice. Confusing to say the least, even if Lestrade had suggested it. And why had it felt awkward being in such close proximity to Holmes? John couldn't remember such awareness creeping in when he'd been in the presence of mates before. There had been the sleeping side-by-side in the army, drunken naked pranks in medical school and the arm- and other sorts of wrestling during seemingly endless pub nights with friends, even the occasional hug at weddings, but never had he felt so acutely aware of the presence of another man as he had down in those archives.

He feels curious.

Intrigued.

He wouldn't go as far as to add 'tempted' to the list, but still.

John reminds himself that he isn't gay. He hasn't ever even considered himself bisexual. It's never been an issue.

John shakes his head as he adjusts his blue cotton cap in front of a hallway mirror.

It's been a strange week. He should just chalk it all up to Sherlock Holmes being such a headcase that he's making John feel weird as well.

Holmes is in fine form that day when it comes to scathing remarks, moodiness and excessive demands. He throws out his assigned scrub nurse, and refuses to proceed until a more senior one is arranged to take her place. The microscope seems impossible to adjust to his liking, the scalpel is dull and everything is wrong, wrong, wrong.

John doesn't receive any of his vitriol, which he considers unexpected. Usually Holmes lays down the law in terms of what he considers anaesthesia's abysmal performance quite early in the course of the operation.

After four grueling hours of Holmes lecturing the rest of the team about their lack of sense, brain cells and proper training, the surgeon finally shuts his mouth and focuses on closing the dural incision.

Harsh, scales-like harpsichord music is drifting in from the speakers.

The scrub nurse shifts her weight and lets her head loll onto her shoulder. She has been on her feet the whole time, holding various instruments, and it's taking a toll on her shoulder muscles. John has often admired the stamina of surgeons and scrub nurses.

"Fuck," Holmes suddenly curses and steps back from the patient.

John stands up from his chair next to the anaesthesia workstation and peers across the drapes to see what's going on.

Holmes is holding up his left hand. His glove is punctured around the thumb, and a reddish blotch is spreading underneath the latex , seeping droplets of blood through the cut.

"Oh great," John sighs and walks around the patient to get closer. He steals a quick look at the surgical field - there's no bleeding or anything else going on that would require Holmes to continue right away after being slipped a second glove on top of the punctured one.

Holmes is standing next to the rubbish bins, hands raised, looking as though he's unsure what to do.

"Come on," John says and gestures for him to walk towards the large sinks in the induction area.

Holmes will have to rescrub in, including exchanging his sterile coat for a new one, but the wound needs to be looked at.

John walks with the surgeon to the edge of the sink and helps him strip off the punctured glove. John grabs his wrist and twists the man's hand so that he can see the wound. It's small, but bleeding in droplets.

John turns to the assisting nurse while holding the bleeding hand over the sink. "We need a dose of cefuroxime for the patient, and blood drawn from the arterial line to screen for hep and HIV. Could you please arrange that?"

The nurse nods. "Sure thing, Dr Watson."

John then moves his attention back to the wrist he's holding. He starts the tap by waving his arm near the sensor and holds Holmes' finger so that it gets properly rinsed. The man says nothing and his hand hangs almost limp in John's grasp.

"What happened? Scalpel?" John asks.

"Scissors," Sherlock replies, "Never happened before," he admits.

"We all prick ourselves at some point," John tries to reassure him, grabbing a tissue to dry off the finger. The man could well do this himself, but he seems a little... disoriented?

"I don't," Sherlock replies in a petulant tone.

"Nobody's perfect," John says, and half expects Sherlock to argue. He reaches to a nearby table housing supplies for inserting cannules. He pours iodine-containing cleaning solution onto a wad of cotton and dabs the wound with it. Sherlock grimaces. John then dresses the wound with a narrow roll of gauze.

He can't help admiring the hand he's holding. It's not feminine, but not manly either. The thenar is muscular - evidence of thousands of hours of instruments being held. There are calluses on the pads of several fingers and John wonders what may have caused them. Some hobby perhaps? Does Holmes play an instrument? An almost unnoticeable yellowish hue mars the nail beds - smoker? Altogether the hands are nothing short of beautiful, well fitting an operative field as delicate as neurosurgery. John has a sudden urge to intertwine his own fingers between those of Sherlock's-

What the flaming fuck is he thinking?

This needs to stop right now. It's not decent, thinking like that. What has gotten into him lately?

"We're taking blood samples from the patient. We'll need a zero sample from you as well. You could go to A&E, or I could do that right here, whichever you'd prefer," John suggests, carefully trying to keep his tone as neutral as possible.

He pulls a chair next to the sink for Sherlock to sit down on.

"Just get it over with," Sherlock says timidly.

John gathers his kit. Sherlock looks elsewhere while John fastens a rubber tourniquet onto the man's arm. He pulls up the sleeve and then pauses, as his brain is suddenly trying to keep up with what his eyes are seeing in the crook of the pale, thin arm.

Scars. Old puncture marks. Signs of healed thrombophlebitis.

John runs his finger along the skin, feeling for a good vein. The ones that are visible feel chunky under his forefinger, scarred and calcified.

John realizes this is the reason Holmes would prefer for him to take the sample and why he's obviously careful about not cutting himself in the first place - he would not want anything like this on his records. Evidence of what could only be a history of substance abuse. Holmes had mentioned this to John, but to see it with his own eyes feels disconcerting.

The realization hits John like a hammer - Holmes really trusts him. Why?

John finishes his task, slaps a small plaster onto the arm and gingerly pulls down the man's shirtsleeve to cover the area.

He expects Holmes to get up, rescrub and continue with the surgery but he just sits there.

"Dizzy?" John asks quietly. Doctors are not immune to feeling nauseous after being stabbed with needles. John himself mildly dislikes being poked in such a manner, but it's fine when he's performing procedures on patients.

Sherlock shakes his head but doesn't make a move to stand up. John looks down at the man's hands that now hang limp on his lap. He realizes a slight tremor is visible in the man's fingers.

"Sherlock?" John asks quietly.

Holmes lifts his gaze and looks at him. "We solved the case, but what if they still insist that I'm not fit to work with patients?"

John frowns and then realizes what's going on.

This is why Holmes has been exponentially nasty all morning.

It's stress.

He's still riled up because of his upcoming Council hearing and it's affecting his performance. Which is bound to be making things worse. A vicious circle.

John glances towards the operating table. The patient's monitor readings are stable. The nurses are ignoring them, clearly happy for a spontaneous break.

"Look, what if I went to this hearing with you?" John asks quietly.

Holmes looks up, a sudden hope lighting his gaze. "You would?" he asks suspiciously.

"Sure," John says, gritting his teeth. The hearing is probably held during office hours, which will take some more creative maneuvering of surgical schedules on John's part.

Oh fuck it. It seems that fate is insisting that John needs to spend some more time in the presence of Sherlock Holmes.

End of chapter 6

xxxxxxxxxxxx

 **Author's notes:**

Healthcare workers are truly not immune to getting squeamish when stuff is being done to THEM instead of them performing their work routines on patients. I'm not a stranger to feeling a little woozy after giving a blood sample even though I perform much more... ahem... graphic procedures on patients all the time. That's our lizard brains kicking into fight-or-flight mode, I guess. Not even a medical degree and a lot of practice in witnessing icky things will completely shut it off.

When there's a puncture accident, in my country we need to ask permission from the patient to get a blood sample to screen for blood-borne diseases. I'm not sure what the related legislation is like in the UK.

Surgical scissors are SHARP. You can forgo all comparisons to household clippers - those things are a serious work hazard when properly maintained. And a regular source of lament for surgeons when they're NOT sharp enough.

Thrombophlebitis is an inflammation of a vein. It can be caused by bacteria or a local irritant like a venous cannule. Or the vein being punctured repeatedly with narcotic substances injected into it. I bet you can guess which one is the culprit for the scars in Sherlock's case...

In this chapter I play around a bit with what John is calling Sherlock at different times. Mostly it's Holmes - even in his thoughts, but when things get a bit more emotional the switch flicks almost automatically to Sherlock and John probably doesn't even notice.


	7. A weight off the shoulders

The following Wednesday John relishes a rare opportunity to sleep late. The hearing is held at ten in the morning, and since his superiors had agreed that it would be useless for him to come to work for just 45 minutes, he's allowed a day off. God knows he does enough on-call shifts to warrant some vacation time anyway.

He puts on his best but still quite worn suit and takes the Tube to Regent's Place. The offices of the Medical Council are located on Euston Squary, which is practically next door from the station.

John walks to the info desk of the somewhat nondescript building, and they tell him where to find the right conference room. When he walks in fifteen minutes before the assigned time for the hearing, Holmes is already there.

The man is dressed impeccably. His navy suit fits like a glove, revealing his athletic curves and accentuating his narrow shoulders. His raven curls have been combed into submission with more product than is decent in John's books, and he's fiddling nervously with his phone. John walks up to him and lets the tips of his fingers land on the man's shoulders.

"Hi," John says.

Sherlock looks up, slightly startled. "You came," he says, looking surprised.

"Of course. I promised, didn't I?"

Holmes is about to say something, when a lanky man in his late sixties walks in. John thinks he might have some Scottish blood - he has a ginger beard with a matching head of thinning hair. There is a most determined expression on his world-weary facial features. He is wearing an uninformal plaid shirt, corduroy jacket and black trousers.

When gaze lands on Holmes he changes his intended course and practically flounces to the man.

Sherlock stands up, straightening his spine. To John he looks tired. "Dr Baxter," Sherlock says with a cold tone.

"This your barrister then? Smart move, bringing one, not that it'll change anything," Dr Baxter says with a scornful tone.

"This is not my solicitor. This is my anaesthetist," Holmes says, not shying from the daggers Dr Baxter is staring at him.

The man harrumphs and takes a seat in the front row. Sherlock slumps back onto his chair.

John sits down next to him. Somehow Sherlock doesn't seem all that nervous anymore.

"_Your_ anaesthetist?" John asks, cocking his eyebrow.

Sherlock glances at him sideways, looking distracted. "You're an anaesthetist, and you're here on my behalf. I'd say the nomenclature is quite accurate."

John smiles and shakes his head.

His amusement turns out short-lived, because the clock has not stopped moving, and the hearing begins.

The chairman opens the proceedings, introduces the case and then asks Dr Baxter to explain his side of the story. The man manages to make his case without sinking too much into the emotional side of things, although he does state that his wife was a wonderful, smart, loving and fun person and that being deprived of her has been the greatest tragedy of his life. He paints a horrifying picture of Holmes, from the vindictive manner in which Holmes has dealt with the accusations to the tiniest details of his lacking bedside manner when interacting with Mrs Baxter.

After Dr Baxter concludes his part, it's Holmes' turn.

He goes to sit in the chair before the podium where the Council is seated, opens his jacket buttons with slightly shaky hands, straightens his spine and then concisely explains the hard facts of the case. He also explains the discrepancies in the records, and states that it was due to clerical and not physician error that the patient's open foramen ovale was not taken into account when planning the surgery. He informs the Council that air embolism is a rare but not always avoidable complication in posterior fossal surgery, and that the anaesthetists had promptly and accurately addressed the issue. He concludes that the patient had perished not because of erroneus conduct in the surgery, but because such a small amount of air would not cause unexpected and sudden cessation of brain functions in patients with no patent holes in their hearts.

The Council retreats to another conference room for forty minutes to discuss the case. Holmes doesn't rise from the chair he still occupies even though his part of the hearing is now done. Not once does he even turn towards the back of the room.

John realizes the man must be agonizingly riled up, almost frozen in place. John wonders if he should walk up to the man and do something, say something, but in the end he refrains, perhaps more for his own sake than Holmes'. It's fine for him to be here and offer moral support, but somehow approaching Holmes when the man is in an emotionally precarious state is making John feels strangely conflicted.

What should he do?

What would people think?

And why does that question even occur to John at a time like this?

Bloody Holmes, making everything so damned complicated.

The Council pours back into the conference room and take their seats in the front. The chairman is smiling in a polite manner. He clears his throat and addresses the room. "The Council has decided to dismiss the case on the grounds that no physician error was made. We will, however, be filing a complaint with the National Hospital For Neurology and Neurosurgery for a professionally unacceptable manner in which patient identity was not verified in the processing of written records. As for the other matters regarding Dr Holmes' professional conduct, we have decided to solve the matter through mandatory counselling by a senior staff member. Dr Holmes, should the Countil appoint a colleague to this task or do you have a person in mind you would feel comfortable discussing such matters with?"

Holmes stands up and turns to face John, smiling tentatively and raising his brows.

John swallows and meets his gaze. He nods and Holmes whips his head around back towards the chairman. "I want Dr John Watson."

"Very well. The matter is resolved, and the Council adjourns."

John follows the rest of a sparse crowd out. He lingers in the foyer, waiting for Holmes to exit the conference room but the man never materializes. He must've left down the other stairway at the end of the hall. A bit impolite, really, not even coming by to say something, but what was John expecting?

Counseling.

John doesn't think it likely that the man would ever actually go through with such a thing. Holmes will probably just suggest that John just signs his name on some bogus report card.

Convenient. That's what John has probably been for him. A little batting of those indecently long eyelashes, and John would do his bidding, fix his career and then fade into the woodwork?

This ought to be perfect for John - after helping the man he would likely have to suffer much less bullying during Holmes' surgeries, and he wouldn't have to actually spend any time with the man.

If this was the perfect endgame for the both of them, why was there a heavy cloud of disappointment hanging over John?

John is about to leave, when he notices Dr Baxter walking towards him.

"Dr Watson?" the man inquires.

John smiles but it doesn't reach his eyes. "Yeah. How are you doing after today?"

Dr Baxter no longer looks as bitter as he did a few hours prior. Now he mostly just looks tired. "At least we now know what happened."

"My condolences for your wife," John offers.

"Thank you. I have to admit I feel a bit sorry for you, lad," Dr Baxter says with an evaluating gaze.

John raises his brows.

"Having to try and counsel that brute," Dr Baxter clarifies.

"He's a good surgeon," John says because nothing else relevant comes to mind.

"That he might be, but he's certainly not a very nice human being. Good luck nevertheless," Dr Baxter says, "I think you'll need it," he adds, puts on his woollen hat, tips it to John, and disappears down the staircase.


	8. Blood boiling

It's Saturday and John's turn to be on call. The first half of the shift keeps John busy with fracture repairs, unco-operative drunks with head injuries needing sedation for CTs, and an extrauterine pregnancy requiring urgent laparoscopy.

Finally, after ten in the evening, John gets to retreat to the on-call room.

He starts to drift closer to sleep but a gurgling water pipe in the ceiling prevents him from actually falling properly into it. He's quite content to just lie in the dark room, eyes closed.

Sometime later he's still only half asleep, when a scratching sound begins in the direction of the door. As far as John knows, he has the only key to the room currently in his shirt pocket.

Nevertheless, the door opens.

John grabs his phone from the nightstand, wondering if he's missed an urgent call and the intruder is a nurse who has come to fetch him in person.

There are no calls. John drops the phone back onto the nightstand and calls out a hello. There's no reply.

John quickly sits up in the dark, trying to peer at the intruder, who closes the door behind them. There are some footsteps, a crashing sound as a chair is knocked over, and then the table lamp is lit.

John blinks in the abrupt brightness.

The visitor is Sherlock Holmes.

John's brow furrows. He climbs out of bed, shivering slightly as he is only wearing his boxer shorts and the upper half of his scrubs.

Before he can inquire what is going on, Sherlock Holmes steps closer, grabs his right shoulder with his fingers, snakes his left hand behind John's head, and yanks him closer.

He then covers John's lips with his own.

The kiss is possessive, ravenous even, and a tongue is introduced quite early in the proceedings.

Flabbergasted and alarmed, John pulls himself free and stumbles backward after allowing himself perhaps a second of being frozen in place while being kissed by Sherlock Holmes.

"What the bloody fucking hell -" John asks, hating his own breathy voice.

Holmes is standing perfectly still, right hand still slightly outstretched. "I'm-"

John slumps down onto a sitting position on the bed. "Seriously, Sherlock, what the bleeding hell is going on?!"

"I assumed this is what you meant," Holmes explains defensively, crossing his arms.

He's wearing a dress shirt and pants. John has no idea if the man is even on call tonight. There hadn't been any neuro cases during the evening.

John doesn't even want to entertain the idea that Holmes might've made his way back into the hospital just to stealthily snog him in the on-call room.

"You've got me completely confused here," John says and realizes his right forefinger has flown up to his lips where a memory and the aftertaste of the kiss still lingers. He drops his hand. Sherlock watches his movements, his lids narrowed into a piercing glare.

The kiss had been... Not what John would have expected, if he had ever even had any expectations of what it would be like to kiss Sherlock Holmes.

John reminds himself that he doesn't do blokes. Ever. Sure, he had sometimes allowed himself to appreciate the view of his fellow soldier's well-formed posteriors in the showers and laughed at the occasional pass at gay bars his girlfriends had dragged him to, but this?

The kiss had been... Good. More than good.

"When you told me that helping me was quote, not a big deal, end quote, and you never stated what a suitable counter-favour would be, I assumed you were being purposefully coy and wanted me to deduce the rest. A tryst with me would not be something you would advertise. You are now privy to my secrets. We would be even."

"You would have sex with me to what end? To get even?!" John dissolves into hysterical laughter.

"You are attracted to me," Holmes says thoughtfully.

John opens his mouth to protest but Holmes holds up a finger. "Don't give me that look. Practically everyone is. It's a cross I must bear."

"I sure hope this is the first time that you've tried to use that as a way to enhance collegial relationships."

Holmes is looking down at his shoes, a slightly pinkish hue spreading on his cheeks.

John gapes. He has made Sherlock Holmes, the cold, unbearable, incorrigible meanie, blush.

"No, I can't say that I have done this before, no," Sherlock replies after some further floor-inspecting. "I always thought it sounded so blasé, the whole fellatio in the on-call room thing."

"The what in the what?" John stammers.

Holmes looks at him as though he is a little daft. "The tales of such exploits are numerous. Supposedly it is a quite common manner in which to settle interhospital power structure issues."

John leans his forehad on his hands. "Sherlock, seriously-" He turns to face the man. "Look, that's an urban legend that some arsehole surgeons like to spread among young, gullible female medical students. And it's stupidly reinforced by all those hospital TV dramas."

"But surely you, with your reputation as a ladies' man, have experimented with-" Holmes suggests.

"I can't say I've ever had the pleasure. In the on-call room, I mean," John hastily adds.

He's discussing his sex life with Sherlock Holmes.

Cows are going to fly, aliens land and the polar caps melt with a pop. It's all going to be in the morning papers.

Holmes sits down next to him on the bed. Strangely enough, John doesn't really mind. The man has just tried to seduce him, but somehow John doesn't feel intimidated at all. Amused - yes, flattered - perhaps, tempted...

If he's honest to himself, he has imagined certain... Scenarios. And they went even further than just a bit of kissing.

John shakes his head quickly. He's tired, his head is messed up and Sherlock Holmes is batshit crazy. Really not the time to start reconsidering one's sexual sensibilities.

"I have to admit that usually people are much more forthcoming in what they want, when they come seeking for favours," Sherlock muses.

"You came to me for help, remember?" John says.

"You could have told me to sod off."

"Does that happen a lot?" John asks.

"All the time," Holmes says and there isn't a hint of amusement in his voice.

John practically gapes. Is this how it's been for Holmes? Have gestures of friendship been so rare or non-existent, that the first one he comes across, he mistakes for an attempt to garner sexual favours, because he can't figure out what else anyone could possibly want from him?

"Listen. I helped you out because you were honest, you were in trouble and I think you're a damn great surgeon. You just need to work on your... People skills," John offers.

"Patients tend to take my attempts quite badly. I've never had an opportunity to practice these things. Or anyone to discuss these things with, apart from those idiot therapists."

John lays his hand on Holmes' shoulder. It should feel awkward but it doesn't. "Well, now you do."

Holmes doesn't reply but turns to face John, who resist the urge to flick away one of Sherlock's gloriously shiny black curls that has flopped onto the man's cheek. They must be a handful to beat into submission each morning.

The silence feels like it needs to be interrupted. John clears his throat. "So you're kind of gay, then?" he asks and wants to bite his tongue afterwards.

Very suave, Watson.

John decides to chalk it down to the late hour and all the stress.

"'Kind of gay', John? Very eloquent and politically correct for a physician, I'd say. You do not approve?"

John's expression is pained. This is not how he'd intended the conversation to go. "No, no, it's not, I'm not, well you are, but- I didn't mean that, you idiot. It's fine. It's more than fine," he offers.

"Is that so?" Holmes inquires, looking suddenly rather hopeful and interested.

"No, I didn't mean it that way either. It's- I'm rubbish at this, okay. Must be nice for you to find something like this that _I'm_ rubbish at," John says, scratching his neck.

Holmes stands up. "I should go," he offers.

What's the right answer here? Quick, Watson, think, before you fuck this up.

Fuck what up? What exactly is this?

"Thanks for... Popping by?" John says and after a moment's bewildernment, Holmes laughs briefly, and leaves the room.

John shakes his head, lets himself flop back onto the bed, and pulls the duvet back over himself.

A small voice inside his head is calling him a bloody idiot. It sounds a bit like Sherlock Holmes.

Not that John hadn't been... Interested, but surely it would've been a bad idea to let things go on since the motive here was all wrong?

Two days later, John is changing out of his scrubs in the afternoon, delighted at the thought of an evening relaxing at home after several emergency cases had bulldozed his whole OR schedule and turned a mellow workday into completely chaos.

He hasn't seen Sherlock since their... Encounter in the on-call room. There had been several moments during which John had wondered if he ought to pick up the phone and tell Sherlock... what exactly?

John's locker is in a separate nook in the locker labyrinth of the doctor's basement lounge. A group of his colleagues are heading home as well, and John can hear them chatting on the other side of a wall of cabinets. The lounge is used by doctors of many different specialties, so John is rarely familiar with all who are present, but now he can at least make out the voice of Philip Anderson.

The Botch.

Then another familiar voice joins in the conversation Anderson had been having. John pauses, T-shirt in hand, to listen.

"Philip?" Sherlock's voice inquires politely. John frowns.

"What?" Comes the aloof reply.

"I have noted that your shunts tend to veer slightly too much towards the left ventricle, which is why they rarely work adequately. If you'd like I could perhaps give you some pointers on proper insertion," Sherlock offers in a neutral tone. It doesn't sound as though he's trying to wind Anderson up, but John doubts the man will take it any other way.

"Did Lestrade put you up to this?" A clearly dismayed Anderson asks Sherlock. "I thought you were smarter than to be his errand boy. It's politics, Holmes, nothing to it. Human relations," he articulates slowly as though talking to a toddler,"Those annoying things that so confuse you."

"I was merely offering assistance-" Sherlock quickly tries to correct.

"No. You were being the major smartarse that you are. I have no idea why Watson puts up with you. Clearly he has the patience of a saint. Voluntarily taking on your surgeries? Or maybe he drew the short straw or lost a bet." Anderson guffaws. The colleagues he'd been talking to before don't seem to want to interfere.

Anderson isn't done yet. "I heard you bedded all of the nice-looking male nurses at the National. Word of advice: I sure wish you're not pinning any hopes on Watson in that sense - he's got too much fucking self-respect to fall for you. Even if he batted for your team, I think he'd want someone more..." Anderson pauses and John draws in a breath, "...Manly. Someone with at least... Less girly arms," Anderson snarls and there's a chuckle in the background. John grits his teeth and quickly puts on his T-shirt, preparing to join the conversation.

"I don't take advice from a surgeon who kills more than he cures," Holmes spits out venomously.

Anderson doesn't reply, but there's an odd sort of a cracking sound and then silence. Alarmed, John finishes quickly changing clothes and then walks into the larger opening between rows of lockers.

John's eyes widen when he takes on the scene. Sherlock is sitting on a bench with a white, crumpled up T-shirt pressed against his nose, which seems to be bleeding. He's only wearing the bottom part of his scrubs.

Anderson and the rest of the group seem to have left so it's just the two of them in the lounge.

John hurries to Sherlock's side. "Fucking hell. Anderson did this?" he asks incredulously.

Sherlock rolls his eyes at him. "You heard everything?"

John gently wrestles control of the T-shirt from Sherlock and lifts it so he can see better. He gently feels Sherlock's nose from the tip to the cartilage at the top. It's swollen but looks symmetrical.

"I don't think it's broken," John concludes, "You'd need a CT to be sure."

Sherlock flicks his hand dismissively at the suggestion, and grabs the wad of wetted tissues John brings him from the shower area, pressing them onto his face.

"Do you want to make an official complaint?" John asks, biting his lip. Sherlock really should, but it's unlikely to make his position any easier in the department. Despite his flawed medical skills, Anderson is quite adept at making life hell for the colleagues he dislikes. This is assault, but John doubts that the colleagues who had actually seen what happened would side with Sherlock instead of Anderson. Goddamned hospital politics.

Sherlock shakes his head. John steps back, unsure what to do next. Sherlock's eyes are downcast and John realizes the man hasn't even looked at him after John had appeared.

"Look, I know you probably didn't mean to piss him off," John offers.

Sherlock gives him a resigned glance. "I was trying to heed your advice, you know, 'be nice to people'," he says bitterly, "I had no idea he would resort to violence."

John's laugh is hollow. "I should've added, 'Avoid those who already hate you'."

"And in all cases, don't be surprised to get whacked with your own olive branch."

"That, too." John says and sits down next to Sherlock, who tentatively lifts the wad of tissues away from his nose.

It has stopped bleeding. Sherlock throws the tissues into a nearby trash bin and then inhales sharply, suddenly looking rather embarrassed. He grabs the top part of his scrubs and holds it against himself as though trying to cover up.

John frowns.

"I didn't, you know," Sherlock offers, running a nervous hand through his curls.

"You didn't what now?"

"Bed... them. Any of them. At the National. Or here. I've nev-" Sherlock suddenly snaps his mouth shut and stares at the opposite wall with a stubborn expression, still cluthing his scrub shirt against his torso.

John leans back on the bench and decides to ignore the last bit. For now. Lest his imagination run wild. "That's none of my business, really, but no, I didn't you did any of those things. That was just Anderson's mouth running off on its own."

"I doubt many would have taken up on the offer anyway," Sherlock says.

John is confused. "Why?"

"As Anderson so poignantly put it, I am not the model of masculine beauty standards. I am pale, thin and lack substantial musculature."

"A little hung up on the girly arms thing, now are you?" John asks, smiling sympathetically, "Which you don't have, by the way. Have you looked in the mirror lately? Or ever?" he asks and stifles a laugh when he sees Sherlock's confusion.

"I don't know what you mean."

John takes in what he can see of Sherlock. An athlete's body with sculptured lines. Visible edges of abdominal muscles. Slender arms, shoulders not too wide but not narrow either. Perfect proportions. Cheekbones sharp, a divine cupid's bow and a black, unruly mop of hair that's practically begging for John to grab between his fingers and tug. John draws in a breath.

Whatever doubts John had about whether he was attracted to this man have now vanished.

"Besides, you're perfectly... fine when you talk to people like this," John blurts out, trying to steer the conversation back to safer ground.

"You're the only one I talk to like this. With others, I try to be assertive. I can't even tell if someone is... interested. My interpretations on that front have recently proven to be false," he says pointedly.

John curses silently. "Look, Sherlock, you weren't-"

You weren't wrong. You weren't wrong but this is hard for me, too? You weren't wrong but the whole scenario is more than a bit confusing? Because you weren't wrong but judging by what you were trying to say neither of us really know what the hell we're doing?

Sherlock looks up. "I talk to you because you seem to think I have hopes of one day passing for a normal human being," he admits.

John smiles. "There isn't anything wrong with you, it's just who you are, the stuff that's difficult for you, like you yourself told me. It's okay to be disabled," John offers.

Sherlock's eyes widen and he looks taken aback. "What did you just say?"

John's brow is furrowed. He's not sure what has caused the change in Sherlock's mood. "I said it's fine, I meant your Asperger diagnosis and all."

"You said that I am dis-" Sherlock doesn't even finish. He stands up, not sparing one look at John and storms out, banging the lounge door shut behind him.

John lets his head loll back against the locker door in defeat.


	9. Weak at the knees

John doesn't catch a single glimpse of Sherlock for two days, because the outpatient clinic the surgeon mans on Tuesdays is in another building and there's a neurosurgical conference taking place in a neighbouring hospital that requires Holmes' presence. John was supposed to attend as well, but they still have several anaesthetists on leave so he is forced to stay on the OR floor.

On Thursday morning Lorna, a nurse from the outpatient clinic hurries after him as he's walking from the locker lounge to a staff meeting. "John?"

John slows his steps but doesn't stop since he's already running late. Lorna matches his pace towards the administration building. "I hate to ask, but..." she starts, sounding hopeful.

John stops and sips the coffee he's holding. "Shoot." He has always liked Lorna. She understands anaesthesia's point of view, has a lot of experience, is very good with patients of all ages and does her work with confidence.

"It's Dr Holmes' Friday case. I know he's doing a preop visit today, and I was hoping you could sneak in and make sure it goes okay," Lorna suggests.

"I'm not his babysitter," John says, "if there's a problem you should take it up with Lestrade. Besides, as far as I know there haven't been all that many complaints from patients lately," John says. He has no idea if this is the case but he doesn't like to talk down colleagues. On the other hand, he usually doesn't obfuscate to help their reputations either.

"John, I know, I know, but it's just that I really don't want this family to go through anything worse than they have to." Lorna is practically begging.

John exhales, looking apologetic.

Lorna bites her lip. She's clearly serious and not about to drop the case anytime soon. "The patient's name is Noah. He's five, John. He's got a medulloblastoma. Mom's friends with my neighbour. They're in shock. I'm not having Holmes trample all over these people," she says determinedly.

John closes his eyes. Lorna's right. John digs out the week's OR schedule from his pocket. One of the senior registrars has been assigned to the case, and with people off sick, in all likelyhood John will be the one to supervise anyway. "Have you any idea what time Holmes is headed to the paeds ward?" John asks.

Lorna's eyes light up. "After two, I think, since that's when their staff meeting ends. John, I'll owe you one. Or two. Or a hundred."

John smiles. "Don't worry about it."

At two in the afternoon, John lingers outside the patient room assigned to Noah Gilliam, age five and a half years.

Holmes strides down the corridor at five past two. His steps come to a screetching halt when he spots John. His gaze is cold. "What the hell are you doing here?" Sherlock demands.

"I'm on the case tomorrow," John answers, trying to sound like what he's said is somehow self-evident.

"Anaesthesia usually does separate preop visits." Holmes reminds him in a suspicious tone. "You're here to spy on me." It's not a question, it's an accusation.

"The preop nurse thought that I should join you," John explains.

"Do you always do the nurses' bidding? Quite unbecoming of a physician to allow oneself to be bullied like that."

"They did assign me as your counselor for these sorts of things," John reminds him.

Sherlock looks like he would prefer the sun to go supernova than to continue such a relationship. He says nothing further to John. Instead he straightens his jacket, opens the door and walks in, John trailing behind him.

At least Sherlock doesn't try to slam the door in his face.

What they've entered is a single room with an adjustable hospital bed suitable for a child less than ten years old. On the bed sits a boy who seems to be the right age to be their patient. He looks pale as he scrutinizes a page in the book he's holding.

Next to the bed, a thirtysomething blond woman is cradling a baby. In the corner, a man whose facial features much resemble those of the little boy's, is talking on the phone. He quickly ends the call when he notices the doctors enter.

Holmes ignores the parents altogether, grabs a chair and plonks it next to the bed.

The little boy looks up, studying Holmes' face. He doesn't look alarmed. He must be getting used to strange people appearing in this room at all hours already.

"Hello Noah," Holmes says, sounding not cold but not exactly very empathetic either.

"Hi," Noah answers shyly.

"I'm Doctor Holmes. I'm a surgeon. Do you know what that means?"

Noah frowns and then nods. "You cut people open," he replies. The mother looks alarmed but John tries to reassure her with a sympathetic glance. It seems to work for now.

"Do you know why?" Holmes asks the boy.

Noah fingers the book he had been holding, now lying next to him on the bed where he had dropped it. "You try to make people better."

Holmes smiles slightly."Very good."

He glances at the book Noah is now holding. "'The Big Book of Brains'", Sherlock reads from the cover. It's a children's book John has seen before - geared towards school-aged children, it explains all sorts of things about how the brain works and what can go wrong with it.

"You can read?" Sherlock asks, not exactly sounding surprised. Noah nods proudly.

"Have mummy and daddy explained why you're in this hospital?" Sherlock then inquires.

John exchanges a worried glance with the father, who takes a step closer. "Dr Holmes, we haven't really, we thought he'd be scared, maybe we should talk without Noah first-"

Holmes silences him with a single glance and turns back towards Noah.

"The other doctor said that there's a tumour in my head. They thought I wasn't listening."

The mother passes the infant to the father and turns away, tears falling down her face. John passes her a tissue, watching Sherlock carefully.

"Do you know what a tumour is?" Sherlock asks.

"It's something bad. My fish had a tumour. It died," Noah says, lower lip quivering.

"Well, your fish didn't have a good surgeon now did it?" Sherlock asks and Noah stares at him.

"Are you a good surgeon?" Noah asks, fingers curling into the duvet he's sitting on.

"Yes, I am."

"Can you take away the tumour?"

"I will try my best to do just that."

"Do you have to cut my head open for that?"

The fathers tries to open his mouth but John lifts his hand to stop him.

Sherlock looks apologetic. "It's a bit like if you have a clock that no longer ticks, it needs to be opened to repair it."

Noah nods. "Are you gonna do it with a saw?" he asks, sounding very nervous.

Sherlock shakes his head. "No. We have better tools for that."

"Daddy fixes computers. He says that the tools you can buy in the supermarket are not small enough or the right shape for computers."

"Well that's how it works with the brain as well. We have special brain tools."

Sherlock turns in his seat point at John. "This is Dr Watson. He will look after you the whole time when I work. He'll make sure you're asleep and don't feel a thing while I take out the tumour. Does that sound okay?"

Noah nods enthusiastically.

Tears are still falling down Mrs Gilliam's cheek but she's smiling now. She steps closer and squeezes her fingers around Noah's shoulder.

Holmes momentarily leans his palms on his knees and then stands up and walks out without a further word.

John can't help but chuckle. Noah has now picked up the TV remote and is flicking through channels. Mr and Mrs Gilliam look a bit shellshocked.

"If you have any questions I'll be happy to answer," John offers.

"No, it's- fine," Mr Gilliam says, sounding surprised at his own words. He looks at his son, who looks as carefree as a five-yeard old with brain cancer could possible ever be and then smiles at John. "It's going to be fine."

After verifying some details of Noah's medical history with his parents, John excuses himself and starts walking down the skybridge towards the adjoining building.

He spots Sherlock standing on a balcony off the skybridge, smoking. He has barricaded the door open with his shoe and is standing at the edge of the balcony with the other shoe in his left leg and just and a sock in his right one.

As far as John is aware these balconies are kept locked. Sherlock must've picked the lock. Unsurprising.

"Those things'll kill you," John remarks and joins Sherlock on the balcony.

"Mm," Sherlock says, not turning to look at him. He seems to be observing the traffic meandering past.

"You were brilliant," John says breathlessly. "And lovely."

Sherlock turns and stares at him for a moment, expression hard to interpret before grinding the butt of the cigarette under his heel. "I remember what it was like to be little, to understand more than the adults ever thought, but get constantly ignored," he says bitterly.

"I'm sorry," John says, "for a lot of things."

Sherlock regards him with a regretful look. "You shouldn't concern yourself with such things."

John bites his lip. "I shouldn't care? You care, judging by what happened two days ago."

Sherlock's scrutinizing gaze seems to scan John's face. "What you said, the term you used was... Accurate but I find it hard to embrace that... notion."

John stops leaning onto the railing and straightens his spine, not shying from Sherlock's piercing gaze. "Forget what I said," he tells Sherlock, "what I should've said is that you should stop putting yourself down. I think you're absolutely amazing and bloody gorgeous and we're going to fix that little boy. Because you can do that. And I get to help. The rest of it doesn't matter. Anderson and the rest of the clowns can go fuck themselves."

Sherlock is staring at him with a confounded expression.

John smiles and delivers a chaste but sincere, lingering kiss on Sherlock's cheek somewhere on the soft bit just in front of the ear. Sherlock closes his eyes momentarily.

John steps back, admiring a repeat of the adorable blush he has witnessed once before. John makes a decision to try and produce a repeat of it every chance he gets, although Sherlock will likely murder him with his bare hands if anyone else ever witnesses such a spectacle.

Sherlock blinks. Twice. "I don't know how to respond."

"Well, you could ask me again to join you for a pint," John suggests.

Over the next weeks, they devise a system. John accompanies Sherlock to all of his preoperative visits and Sherlock uses John's reactions to gauge when to shut up. When things go tits-up like they still often do, John proverbially mops up the mess.

They meet up for lunches and discuss some basic things about listening, showing empathy and answering questions honestly but encouragingly. Sherlock is suspicious, but eager to learn when it comes to John's advice, and some of it begins to actually rub off. His conduct, when he's trying to be nice, still seems a bit theatrical, as though scripted, but it's still a major improvement to leaving patients and their loved ones in tears.

In the OR, they slowly develop into a formidable team. John begins to enjoy the days he's assigned to Sherlock's cases. Sherlock still insist on no conversation and playing his own music when he's wielding the scalpel, but John convinces him to introduce some well-known post-Baroque compositions into his collection, and a couple months later the whole OR team is humming along to a familiar passage from Wagner's Lohengrin.

After four weeks, Sherlock's nose is still slightly swollen. An official complaint about Philip Anderson is filed by John after dragging Sherlock to see one of the hospital's otorhinolaryngologists. The fact that only one participant in the argument has a hairline fracture in their nose after all tips the scales in Sherlock's favour when the event is evaluated by their superiors. Anderson receives a warning - his second ever, and seems to decide to lay low. For how long, no one knows.

It's a Monday in March when Sherlock finally accepts an invitation from John to join him and some other doctors for a cafeteria lunch. Before he has always declined with some transparently flimsy excuse. Based on everything John has now learned about the man, he has deduced that the reason has probably been his worries about what others think of him, and his difficulties in reading other people's reactions.

During the meal, Sherlock brings up John's still dismal housing situation and tells him that months after the Council hearing, Dr Baxter had contacted him, having decided that the most important thing was that the mystery of her wife's death had been resolved, and that a young lad like Sherlock deserved another chance. The man had then offered Sherlock one of the apartments he owns as a side business as a rental for a nominal fee. A collegial peace offering.

"It would be a terrible waste, all that space just for myself. I hardly take up any. Besides, it would be convenient to share some of the chores."

John twiddles a forkful of roast beef in his fingers. "What are you saying?"

"I'm saying we ought to be flatmates." After this announcement, Sherlock gazes around the table nervously. No one looks alarmed, judgmental or mocking, so Sherlock focuses on attacking his mashed potatoes with his cutlery.

"I think-" John says with a wry expression, "I'd very much like that."

"Excellent. You could drive us to work," Holmes then ventures to suggests, beaming.

"Can't you drive yourself? We don't always have the same shift schedule, you know."

"I don't have a driver's licence. Never learned to drive. My parents always had a chauffeur and after I turned eighteen and moved to London, driving never seemed all that convenient."

"Well, I don't have a car so the Tube it is," John says.

"I have one," Sherlock says, digs out his phone, taps some keys and a picture of a car appears. A very nice car. A very, very, very nice car.

Dr Marsh, a cardiologist with a penchant for golf and such cars, leans into peer at the phone screen. He whistles. "Is that a BMW M5?"

Sherlock nods.

"Fucking hell," Marsh says in a very appreciative tone.

John is astonished. "You bought a car when you can't even drive?"

"My fellow surgeons at The National were clearly of the disposition that such a car was a part of proper lifestyle for a succesful surgeon."

John leans his head on his fingers. "You're a brilliant idiot."

"That's an oxymoron, John." Sherlock pockets his phone.

"That is some sort of a moron alright," John says, smiling.

"If you're done berating me for reasons unknown, I would like a confirmation that the housing issue is settled." He looks expectant, biting his lip in a nervous manner.

John takes a moment, forking peas into his mouth.

The past few months have been interesting to say the least. He has broken into a hospital, kissed a man, seen some of the most exhilarating and amazing surgical work in his career and had fun. So much fun. He no longer fears going home to his bleak apartment, because he knows that he will see Sherlock the next day at work. The only thing he still hates are weekends, when there's nothing exciting happening.

Living with Sherlock could fix that, couldn't it?

After the chaste peck on the cheek on the balcony they have been sort of circling one another, both perhaps waiting for the other to make a further move. The flutter in John's stomach that he had at first tried to ignore, but which like a very persistent itch kept coming back and distracting him, is getting worse. It's currently making his gaze wander to certain physical attributes of the neurosurgeon currently seated across the table.

The luminous, interesting, ridiculous, insecure, mysterious, trusting, vile, barking mad, gorgeous Sherlock.

The car might also be a nice perk.

"Yes," John says. "Yes, to all of it."

"There's just one problem," Sherlock replies, looking deadpan.

John raises his brows.

"There's... Only one bedroom," Sherlock says quietly, glancing around. No one seems to be listening.

John draws in a breath. He realizes that when Sherlock had announced that John was attracted to him, John had never asked whether the opposite was true as well. That issue seems to be settled now, judging by the unmistakable glint in Sherlock's eye and the warm palm that has now snaked its way onto John's knee underneath the table.

"I think we could make it work," John says, smiling.

\- The End -


End file.
